Sodium-glucose cotransporter 2 inhibitors for diabetes mellitus control after kidney transplantation: Review of the current evidence
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Sodium-glucose cotransporter 2 inhibitors for diabetes mellitus control after kidney transplantation : Review of the current evidence. / Kanbay, Mehmet; Demiray, Atalay; Afsar, Baris; Karakus, Kagan E.; Ortiz, Alberto; Hornum, Mads; Covic, Adrian; Sarafidis, Pantelis; Rossing, Peter.
I: Nephrology, Bind 26, Nr. 12, 2021, s. 1007-1017.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Sodium-glucose cotransporter 2 inhibitors for diabetes mellitus control after kidney transplantation
T2 - Review of the current evidence
AU - Kanbay, Mehmet
AU - Demiray, Atalay
AU - Afsar, Baris
AU - Karakus, Kagan E.
AU - Ortiz, Alberto
AU - Hornum, Mads
AU - Covic, Adrian
AU - Sarafidis, Pantelis
AU - Rossing, Peter
N1 - Publisher Copyright: © 2021 Asian Pacific Society of Nephrology.
PY - 2021
Y1 - 2021
N2 - Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) are promising drugs to treat chronic kidney disease patients with or without diabetes mellitus (DM). Besides improving glycemic control, SGLT2i are cardioprotective and kidney protective and decrease bodyweight, serum uric acid, blood pressure, albuminuria and glomerular hyperfiltration. These effects may benefit graft function and survival in kidney transplant (KT) patients. In this review, we evaluate data on the efficacy and safety of SGLT2i for KT patients with DM. Eleven studies with 214 diabetic KT patients treated with SGLT2i have been reported. SGLT2i lowered haemoglobin A1c and bodyweight. While glomerular filtration rate may be reduced in the short-term, it remained similar to baseline after 3–12 months. In two studies, blood pressure decreased and remained unchanged in the others. There were no significant changes in urine protein to creatinine ratio. Regarding safety, 23 patients had urinary tract infections, 2 patients had a genital yeast infection, one had acute kidney injury, and one had mild hypoglycaemia. No cases of ketoacidosis or acute rejection were reported. In conclusion, the limited experience so far suggests that SGLT2i are safe in KT patients with DM, decrease bodyweight and improve glycemic control. However, some of the benefits observed in larger studies in the non-KT population have yet to be demonstrated in KT recipients, including preservation of kidney function, reduction in blood pressure and decreased proteinuria.
AB - Sodium-glucose cotransporter type 2 inhibitors (SGLT2i) are promising drugs to treat chronic kidney disease patients with or without diabetes mellitus (DM). Besides improving glycemic control, SGLT2i are cardioprotective and kidney protective and decrease bodyweight, serum uric acid, blood pressure, albuminuria and glomerular hyperfiltration. These effects may benefit graft function and survival in kidney transplant (KT) patients. In this review, we evaluate data on the efficacy and safety of SGLT2i for KT patients with DM. Eleven studies with 214 diabetic KT patients treated with SGLT2i have been reported. SGLT2i lowered haemoglobin A1c and bodyweight. While glomerular filtration rate may be reduced in the short-term, it remained similar to baseline after 3–12 months. In two studies, blood pressure decreased and remained unchanged in the others. There were no significant changes in urine protein to creatinine ratio. Regarding safety, 23 patients had urinary tract infections, 2 patients had a genital yeast infection, one had acute kidney injury, and one had mild hypoglycaemia. No cases of ketoacidosis or acute rejection were reported. In conclusion, the limited experience so far suggests that SGLT2i are safe in KT patients with DM, decrease bodyweight and improve glycemic control. However, some of the benefits observed in larger studies in the non-KT population have yet to be demonstrated in KT recipients, including preservation of kidney function, reduction in blood pressure and decreased proteinuria.
KW - chronic kidney disease
KW - diabetic kidney disease
KW - kidney transplant
KW - post-transplant diabetes mellitus
KW - SGLT2 inhibitors
KW - transplantation
U2 - 10.1111/nep.13941
DO - 10.1111/nep.13941
M3 - Review
C2 - 34263502
AN - SCOPUS:85111098142
VL - 26
SP - 1007
EP - 1017
JO - Nephrology
JF - Nephrology
SN - 1320-5358
IS - 12
ER -
ID: 275944102